Early, safe enteral nutrition provides several benefits to critically ill patients, including more rapid healing faster weaning from mechanical ventilation, fewer infections, and shorter hospital stays. A number of feeding tube devices have been developed over the years for the purpose of providing food and nutrients to a patient, such as into a patient's duodenum. For example, U.S. Pat. No. 5,431,640 issued to Gabriel, discloses a catheter guided by an external magnet so as to advance the catheter into the patient's duodenum. In addition, U.S. Pat. No. 6,126,647 issued to Posey et al. discloses a catheter guided by an external magnet, which contains a sensor that indicates whether the distal end of the catheter is being properly advanced into the patient's duodenum. The catheter contains a magnet that is permanently affixed in the distal portion of the catheter.
One current FDA approved device (i.e., the Gabriel Feeding Tube) uses an external magnet to direct duodenal intubation by a feeding tube with a magnet embedded in its tip. A light indicator at the proximal end of the feeding tube, connected to a magnetic field sensor at the distal end, provides confirmation to the operator that the magnet has been captured. In a study previously conducted at the Medical Center of Central Georgia, the enteral feeding tube with light indicator was reliably placed into the distal duodenum in an average of 17 minutes, with 87% success rate in the first attempt. This intubation technique did not require fluoroscopy, endoscopy or medications. Most of the 17 minutes were used to manipulate the tube from the first part of the duodenum to the 4th part of the duodenum. No attempts were made for deeper placements than 4th part of the duodenum as the anatomy is variable in different patients and even in the same patient at different times due to redundant omental attachment of the small intestine.
Risk associated with feeding directly into a patient's stomach is aspiration into the lungs. To minimize this risk, the tip of the feeding tube is advanced distally, ideally beyond the ligament of Treitz. Critically ill patients often have gastroparesis, but their small bowel function usually remains normal. Therefore, nasoenteral feeding in the distal duodenum can allow provision of daily caloric needs without the interruption required by gastric residuals. Unfortunately, placing enteral feeding tubes beyond the pyloric sphincter and even further into the duodenum is difficult. Many currently available tubes coil up in the gastric fundus.
Although known feeding tubes are designed to deliver food and nutrients to a patient, advancement of known catheters into the patient's duodenum continues to present a number of problems as discussed above.
There is a need in the art for improved feeding tube devices that more easily enter into and advance through a patient's duodenum.